HomeMy WebLinkAboutPermit Electrical 2003-04-01SPtlra&Ftar D
City of Springfield
Electrical Perm it Attachment
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-126-3676Fax
541-7 26-3769 Inspection Line
SITE ADDRESS: 1001 35TH ST Springfield
ASSESSOR'S PARCEL No.: I7L23O43OI7OO TYPE OF WORK: RCPAiT
TYPE OF USE: Industrial
PROJECT DESCRIPTIoN: Replace main service panel to -,fl$ltgE1frtfrftx^t t FX'IRE lF THE W'RK
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00095
4nt2003
3t3u2003
r0t1t2003
OWNER/APPLICANT:
SLINDANCE LUMBER CO INC
PO BOX 109
SPRINGFIELD OP.97477
nnnosEffiru80ERffiSdE6HrJ tS N 0T
L{flSIBEHfiFD 0R lS ABAND0NED F9fl-r+z-oors
68Anffi[80 Bill{ffifl|00.
SPRINGFIELD OR 97477
CCB # 8699 Expiration Date: 12/1812004
Description
+ l0% Administrative Fee
+ 7o/o State Surcharge
Perm ServlFdr 1000 amps/volts
Amount Paid
37.50
26.25
375.00
Date Paid
0410U2003
04/01/2003
0410U2003
Receipt Number
1200200000000000925
120020000000000092s
120020000000000092s
By Signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I further
certify that only contractors and employees who are in compliance with ORS 701.055 witl be used on this project. I further agree
to ensure that all required inspections are requested at the proper time, that each address is readable from the street, and that
the approved set of plans, if applicable, will remain on the site at all times during construction.
To Request an inspection call the 24hotr recording at726-3769. All inspections requested before 7:00 a.m. will be made the same
working day, inspections requested after 7:00 a.m. will be made the following working day.
Required Inspections:
1 Electric Service: Approval required prior to utility company energizing service.
Owner or Contractors Signature Date
Paee I of I
225 FFTH STREET' SPzuNGFIELD,OREGO]w97477.,
SPECTiON T: '726-
L mtu*
)
.t.. :.
CONTRACTOR INSTALLATI
FEE S
Nerr'Re.si dential-Single
Mult per du'elling unit.
Includetl:
*
Items Cost
$ r06.00
s 19.00
Sum.
i 000
IHIS PERM
Horne or
Electrical
Address
rr Q rr Street
up crvisin g Electrician
The installation is being made on
prope(J- I orvn rvhich is not intended
for sale, lease or rent.
Oryncr.r Signature
.R. Brabham, fnc.c0
AN
5f5'
Dwelling
or Feeder
IT SHALL
B' *tfirFsnl'EoddliD
'Ui$'Prn
200 amps or
201 arnps to
.101 amps to
601 amps
Over 600
"8" aboye
D. Branch Circuits
Neq,Alteration or Extension Per
Each Additional Circuit or n,itlr
or Feeder Permit
E. Illiscellaneous (Scllice/feerler not inclutled)
-Each installation
Pump or irrigation $50.00
Liniited Energl'/Res $25.00
Linrited Energv/Comm
-
$l5.oo
l\{inimunr Electric Permit Inspcction Fec ir- S45.00 + Sul.chirr.gcs
1. SUBTOTALOFABOVE
7%o Stile Surchirrge
I 1Yl, Administrative Fec
5,M
TOTAL 2 ,' '/5
CitY Job
EL 1]CAL
if work is not'sttrrted
ofissuance or
I 80 days.
spr
4/u2003
2:51:24PM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Receipt #z 1200200000000000925
Date: 0410112003
-ine Items:
Job/Journal Number Description Amount Paid
ELE2003-00095
ELE2003-00095
ELE2003-0009s
Perm ServlFdr 1000 amps/volts
+ l0o/o Administrative Fee
+ 7Yo State Surcharge
Payments:
375.00
37.50
26.25
Line ltem Total:$438.7s
TypeofPayment Paid By Received By Check Number Confirm No How Received Amount Paid
Check L.R. BRABHAM ddk In Person 438.75
Total:$438.75
Page 1 of I cReceipt.rpt
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